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PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1629086673


NPI Information

NPI: 1629086673
Provider Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Classification: Social Worker - 104100000X
Entity Type: Organization
Address:
300 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548
Phone: (616) 455-5000
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PINE REST CHRISTIAN MENTAL HEALTH SERVICES is a social worker in Grand Rapids, MI. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI is 1629086673. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548-927
Phone: (616) 455-5000

The provider's authorized official is Diane Fennema .
The authorized official title is Managed Care Administrator and has the following contact phone number (616) 281-6372.

The enumeration date for this NPI number is 8/4/2006 and was last updated on 11/4/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2104100000XSocial WorkerYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1800D16222OTHERMICHIGANBC/BS SOCIAL WORKER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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